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General Practice 2023

APLV: what é, symptoms, treatment and dúcommon lives

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APLV: what é, symptoms, treatment and dúcommon lives
APLV: what é, symptoms, treatment and dúcommon lives

CMPA is a food allergy to one or more proteins present in cow's milk, such as casein, lactoglobulin, lactalbumin, serum albumin and immunoglobulins, which occurs mainly when the baby or child ingests or has contact with cow's milk.

Also known as cow's milk protein allergy, CMPA can occur immediately or after a few hours or days, after ingestion or contact with products that contain this protein, causing signs and symptoms to appear, such as hives, vomiting, diarrhea and child growth retardation. Learn about other symptoms of food allergy in children.

CMPA usually appears in babies and children, because the immune system is still developing at this stage of life, however, in rarer cases, it can also appear in adults.The diagnosis of CMPA must be made by a doctor by evaluating the signs and symptoms, performing the food intolerance test and the exclusion test, for example.

Main symptoms

The symptoms of CMPA after the consumption of cow's milk vary according to the type of reaction of the immune system, and may appear immediately after, or up to a week after ingestion or contact with cow's milk.

1. Symptoms of immediate reactions

Symptoms of immediate CMPA reactions occur after a few minutes or, at most, up to 2 hours after ingestion or skin contact with cow's milk and include:

  • Redness, inflammation and itching of the skin;
  • Nausea and vomiting;
  • Diarrhea;
  • Abdominal pain;
  • Cough or wheezing;
  • Coryza and stuffy nose;
  • Itchy eyes and watery eyes.

In addition, in more serious cases, symptoms such as difficulty breathing, shortness of breath and a feeling of discomfort in the throat, which is a situation known as anaphylactic shock, can also appear, and should be treated immediately to avoid further complications. See how to identify anaphylactic shock and learn what to do.

2. Symptoms of delayed reactions

Delayed CMPA reactions may appear hours or days after ingestion or skin contact with cow's milk, causing the following signs and symptoms:

  • Bloody stools;
  • Reflow;
  • Constipation;
  • Inflammation in the esophagus;
  • Anemia;
  • Intestinal inflammation;
  • Inflammation in the lungs.

Furthermore, other signs, such as irritability, decreased appetite, and decreased growth may also appear in late reaction to CMPA.

How to confirm the diagnosis

The diagnosis of CMPA should be made by a general practitioner or pediatrician, through the evaluation of the signs and symptoms presented after the consumption of products with cow's milk. The doctor may also order some tests, such as a blood test and allergy skin test, a test that involves putting substances that can cause allergies on the arm or forearm to check for signs of allergy on the skin. Understand how the skin test for allergies is done.

In addition, the doctor can also do exclusion tests, where specific foods are removed from the diet to see if the signs and symptoms improve, until the food that is causing the allergy is identified.

If there is an improvement in the signs with the withdrawal of cow's milk from the diet, the doctor can also do the oral provocation test, which is an evaluation where the child consumes, in a hospital, small amounts of milk and the symptoms are observed.

It is important to remember that the diagnosis of CMPA can take from 3 days to 4 weeks, because it depends on the severity of the allergy and the speed with which the symptoms appear and disappear.

How the treatment is done

The treatment of CMPA should be carried out under the supervision of a doctor, where it is recommended to exclude cow's milk and its derivatives, such as ice cream, cheese, butter and cakes, from the diet. In the case of children, the pediatrician should indicate infant formulas that do not contain cow's milk.

The pediatrician may recommend some supplements to avoid vitamin and mineral deficiencies, which can cause diseases such as scurvy, which is a lack of vitamin C, or beriberi, a type of anemia caused by a lack of vitamin B1, due to example.

Can the baby be allergic to mother's milk?

Babies who are exclusively breastfed may also have symptoms of CMPA, as part of the cow's milk protein consumed by the mother passes into breast milk, causing allergies in the baby.In these cases, the mother is advised to exclude products with cow's milk and dairy products from the diet.

Difference between lactose intolerance and CMPA

Lactose intolerance is a syndrome where the intestine does not produce lactase, which is the enzyme responsible for digesting lactose, the sugar present in milk and dairy products, causing symptoms such as excess gas, cramps and diarrhea, for example. Know the main symptoms of lactose intolerance.

In APLV, in addition to gastrointestinal symptoms, the person may also have symptoms similar to an allergy, such as redness and itching of the skin, runny nose, stuffy nose and, in more serious cases, may have difficulty breathing, lack of breath and a feeling of discomfort in the throat, a condition known as anaphylactic shock.

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